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Original Article Measuring the Sedation Level of Mechanically Ventilated Infants by a Modified COMFORT Scale 改良舒適量表評估機械通氣嬰兒的鎮靜狀態水平 Abstract This prospective observational study aimed to measure the internal consistency and inter-rater agreement of the modified COMFORT scale for mechanically ventilated patients in a neonatal intensive care unit. A sample of 15 infants requiring mechanical ventilation, generating a total of 27 observations, was recruited. Three different observers including a doctor, a nurse and a senior nurse independently assessed the sedation level of each patient. The measurement tool was modified from the original COMFORT scale. The Spearman's correlation coefficients for the inter-rater agreement between doctors and senior nurses, doctors and nurses as well as nurses and senior nurses on the total scores were 0.760, 0.626 and 0.776 respectively, all p<0.05. The reliability coefficient alpha for the internal consistency was 0.804. We suggest that the modified COMFORT scale may be an appropriate tool to observe sedation level for mechanically ventilated infants. More studies may be required for validation and outcome assessment. 這是一個前瞻性的觀察研究,旨在衡量經改良的舒適(COMFORT)量表,在新生兒深切治療用於機械通氣患者使用時的內在連續性及評估者之間的一致性。 15 例需要機械通氣的嬰兒(共觀察 27 次)入選該研究。3 位不同的觀察者包括醫生、護士及高年資護士獨立地評估每個患者的鎮靜狀態水平。評估的工具為原版舒適(COMFORT)量表的改良版。評估者之間總分(即醫生與高年資護士、醫生與護士及護士與高年資護士)一致性 Spearman 相關係數分別為 0.760、0.626 及 0.766,皆 p<0.05。內在連續性可靠性係數 a 為 0.804。我們建議改良舒適(COMFORT)量表可能是觀察機械通氣嬰兒合適的工具。關於有效性及結果評估,也許需要更多的研究。 Keyword : Neonatal intensive care; Scale; Sedatives; Ventilation 關鍵詞:新生兒深切監護、量表、鎮靜劑、通氣
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